Cederström, Björn

Lundqvist, Mats

Fredenberg, Erik

Abstract [en]

Purpose: Digital breast tomosynthesis (DBT) is an emerging tool for breast-cancer screening and diagnostics. The purpose of this study is to present a second-generation photon-counting slitscanning DBT system and compare it to the first-generation system in terms of geometry and image quality. The study presents the first image-quality measurements on the second-generation system. Method: The geometry of the new system is based on a combined rotational and linear motion, in contrast to a purely rotational scan motion in the first generation. In addition, the calibration routines have been updated. Image quality was measured in the center of the image field in terms of in-slice modulation transfer function (MTF), artifact spread function (ASF), and in-slice detective quantum efficiency (DQE). Images were acquired using a W/Al 29 kVp spectrum at 13 mAs with 2 mm Al additional filtration and reconstructed using simple back-projection. Result: The in-slice 50% MTF was improved in the chest-mammilla direction, going from 3.2 to 3.5 lp/mm, and the zero-frequency DQE increased from 0.71 to 0.77. The MTF and ASF were otherwise found to be on par for the two systems. The new system has reduced in-slice variation of the tomographic angle. Conclusions: The new geometry is less curved, which reduces in-slice tomographic-angle variation, and increases the maximum compression height, making the system accessible for a larger population. The improvements in MTF and DQE were attributed to the updated calibration procedures. We conclude that the second-generation system maintains the key features of the photon-counting system while maintaining or improving image quality and improving the maximum compression height.

Berggren, Karl

Abstract [en]

In the 1970s, it was determined that screening mammography is an efficient tool in fighting the increasing number of women dying from breast cancer, and many countries have established screening programs since then. Mammography systems have improved substantially over the years with one of the major advances being the transition from x-ray film to digital x-ray detectors. Following this development, the number of women dying from breast cancer has decreased, but there is still much room for improvement. One technology that is changing the breast imaging landscape is breast tomosynthesis; tomographic imaging with in-plane resolution similar to that of mammography, albeit limited height resolution. Breast tomosynthesis is commonly implemented with flat-panel detectors, but line detectors in a slit-scanning geometry can also be used. The latter configuration allows for more complex detector technologies, such as spectral photon-counting detectors that enable single-shot spectral imaging. The combination of spectral imaging and tomosynthesis opens up for a range of new applications, but the slit scanning geometry, which differs substantially from that of flat-panel tomosynthesis systems, and the factors affecting image quality have not been well understood. This thesis aims at filling this gap. Image quality and the parameters that influence image quality in spectral photon-counting slit-scanning breast tomosynthesis are characterized and analyzed using cascaded-systems modelling and linear image quality metrics. In addition, the thesis goes into characterizing the x-ray properties of breast tissue, an important input parameter for accurate material decomposition of in-vivo tissue. Material decomposition with spectral imaging opens up a range of applications, such as accurate measurement of volumetric breast density and spectral lesion characterization for decision support as part of mammography screening, and contrast-enhanced K-edge imaging for diagnostics. Tomosynthesis combined with material decomposition has the potential to improve these methods further by, for instance, separating lesions or regions of interest from surrounding fibro-glandular tissue in quantitative 3D maps of breast tissue.